Trends of robotic total joint arthroplasty utilization in the United States from 2010 to 2022: a nationwide assessment

The adoption of robotic assistance in total knee arthroplasty (TKA) and total hip arthroplasty (THA) is growing rapidly worldwide. This study aims to evaluate recent trends in the utilization of robotic-assisted TKA and THA across the United States spanning a 12-year period. This retrospective analysis utilized the PearlDiver All Payer Claims Database to identify patients who underwent primary, elective primary TKA or THA between 2010 and 2022. Procedures were categorized as conventional or robot assisted based on International Classification of Diseases (ICD-9), ICD-10, and Current Procedural Technology (CPT) codes. Patient demographics were captured including age, sex, and comorbidities. Annual usage trends for each modality were analyzed. Simple linear regressions were utilized to evaluate changes in the proportion of annual robot-assisted TJA performed over time relative to total procedures. P values < 0.05 were significant. Of the 2,294,076 total TKAs performed between 2010 and 2022, 1.58% were robotic assisted. Similarly, of the 1,235,577 total THAs performed, 1.26% utilized robotic assistance. Robotic TKA accounted for a steadily increasing percentage of total TKA procedures, significantly growing from 0.35% in 2010 to 3.45% in 2022, peaking at 4.39% in 2019 (P < 0.001). Similarly, robotic THA utilization showed significant growth, increasing from 0.26% in 2010 to 2.36% in 2022, peaking at 3.59% in 2019 (P < 0.001). The use of robotic-assisted TKA and THA has seen significant growth across the United States. Robotic TKA and THA have become increasingly utilized technologies, with steady growth in adoption since 2010. Level of evidence: III.